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WO2022016065A1 - Ciblage de l'adipsine pour la stéatohépatite non alcoolique (shna) et la fibrose hépatique - Google Patents

Ciblage de l'adipsine pour la stéatohépatite non alcoolique (shna) et la fibrose hépatique Download PDF

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Publication number
WO2022016065A1
WO2022016065A1 PCT/US2021/041999 US2021041999W WO2022016065A1 WO 2022016065 A1 WO2022016065 A1 WO 2022016065A1 US 2021041999 W US2021041999 W US 2021041999W WO 2022016065 A1 WO2022016065 A1 WO 2022016065A1
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Prior art keywords
inhibitor
adipsin
cfd
liver
rna
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Inventor
Utpal Pajvani
Jinku KANG
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Columbia University in the City of New York
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Columbia University in the City of New York
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Priority to US18/154,728 priority Critical patent/US20230241093A1/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
    • A61K31/7088—Compounds having three or more nucleosides or nucleotides
    • A61K31/7125—Nucleic acids or oligonucleotides having modified internucleoside linkage, i.e. other than 3'-5' phosphodiesters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P3/00—Drugs for disorders of the metabolism
    • A61P3/08—Drugs for disorders of the metabolism for glucose homeostasis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
    • A61P1/16—Drugs for disorders of the alimentary tract or the digestive system for liver or gallbladder disorders, e.g. hepatoprotective agents, cholagogues, litholytics
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P3/00—Drugs for disorders of the metabolism
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P3/00—Drugs for disorders of the metabolism
    • A61P3/08—Drugs for disorders of the metabolism for glucose homeostasis
    • A61P3/10—Drugs for disorders of the metabolism for glucose homeostasis for hyperglycaemia, e.g. antidiabetics

Definitions

  • T2D Type 2 diabetes
  • Compensatory hyperinsulinemia drives hepatic de novo lipogenesis mediated by the nutrient-sensitive mechanistic target of rapamycin (mTOR) pathway (Li, Brown et al. 2010), and couples with an impaired ability to catabolize and export fatty acids (Bugianesi, Gastaldelli et al. 2005), results in excess hepatocyte triglyceride accumulation, which is known as non-alcoholic fatty liver disease (NAFLD).
  • mTOR mechanistic target of rapamycin pathway
  • NAFLD non-alcoholic fatty liver disease
  • Fatty liver disease is a condition in which fat builds up in your liver, of which there are two types: NAFLD and alcoholic fatty liver disease (ALD), also called alcoholic steatohepatitis.
  • NAFLD and ALD alcoholic fatty liver disease
  • ALD alcoholic fatty liver disease
  • the fatty degeneration of liver cells occurs to a greater degree in NAFLD than in ALD (Toshikuni et al. 2014).
  • inflammatory cell infiltration is more pronounced in ALD than in NAFLD (Toshikuni et al. 2014).
  • NAFLD nonalcoholic fatty liver disease
  • NAFLD non alcoholic steatohepatitis
  • NASH defined by hepatocyte damage with associated inflammation and fibrosis, predisposes to cirrhosis and hepatocellular cancer, and is the fastest-growing reason for liver transplantation. NASH has no approved pharmacotherapy - as the prevalence of obesity-related NASH continues to rise, and available livers for transplantation remain limiting, this unmet need grows more urgent.
  • Notch is a highly conserved family of proteins critical for cell fate decision-making, but less is known about Notch action in mature tissue. Notch activity is present at low levels in normal liver, increases markedly in livers from obese patients and diet-induced or genetic mouse models of obesity, but is highest in patients with NASH and shows significant positive correlations with plasma ALT and NAFLD Activity Score.
  • Notch signaling pathway is critical for cell fate decision-making in development, but our published data (Zhu et al, Science Translational Medicine, 2018) prove that "reactivated" Notch signaling, specifically in hepatocytes, induces insulin resistance, and by means of crosstalk with local hepatic stellate cells (HSC) transforms simple steatosis to NASH-associated fibrosis, the major determinant of morbidity/mortality in NASH patients and the likely clinical endpoint of all potential therapeutics.
  • HSC local hepatic stellate cells
  • Recent data suggest the proximal hit to increased hepatocyte Notch activity is increased hepatocyte expression of the Notch ligand, Jaggedl.
  • hepatocyte-specific Jaggedl loss-of-function mice and proof-of-principle pharmacologic (using ASO, and GalNAc-modified siRNA) establish hepatocyte Jaggedl as causal to NASH-induced liver fibrosis in mouse models.
  • Human studies show increased liver JAGGED1 expression across multiple cohorts. In sum, these data indicate that hepatocyte Jagl is a strong therapeutic target for NASH-induced liver fibrosis.
  • RNA sequencing in models of endogenous and forced hepatocyte Notch activity has revealed several interesting candidate hormonal effectors, including two (Osteopontin and MCP1) that have generated pharmaceutical interest and interesting data.
  • Notch activity is further described in U.S. Patent and Application Nos. 61/800,180, 14/814,407, 15/976,534, 62/031,090, 62/242,888, 15/768,701; and PCT Nos. PCT/US2014/026717 and PCT/US2016/057166; the entire contents of which are incorporated by reference.
  • liver disease including NASH-induced liver fibrosis.
  • the present invention provides a method of treating a subject afflicted with fatty liver disease comprising administering to the subject in need thereof a pharmaceutical composition comprising a pharmaceutical carrier and a compound that reduces Adipsin activity in liver cells in an amount effective to treat the subject.
  • Figure 1 shows a graphical representation that Hepatocyte Adipsin expression is increased in NASH and is associated with liver fibrosis from Example 1.
  • Panel A shoes Adipsin (encoded by Cfd) expression in adipose from NASH diet-fed mice.
  • Panel B shows Adipsin (encoded by CFD) expression in liver from NASH diet-fed mice.
  • Panel C shows Adipsin expression in hepatocytes from NASH diet-fed mice.
  • Panel D shows Immunohistochemistry from liver tissue isolated from chow (con) and NASH diet-fed mice, showing abundant hepatocyte Adipsin levels.
  • Panel E shows Western blot from liver tissue isolated from chow (con) and NASH diet-fed mice, showing abundant hepatocyte Adipsin levels.
  • Panel F shows experimental schematic for shCfd experiment.
  • Panel G shows knockdown of hepatocyte Adipsin reduces liver fibrosis in NASH diet- fed mice.
  • FIG. 1 Adipsin/C3/C3arl expression in NASH.
  • A Adipsin gene expression in isolated hepatocytes (parenchymal cells, PC) or various non-parenchymal cell (NPC) populations in chow- and NASH diet-fed mice.
  • B Complement C3 gene expression in isolated liver PC and NPC in chow- and NASH diet-fed mice.
  • C C3aRl gene expression level in isolated liver PC and NPC in chow- and NASH diet-fed mice.
  • D Complement C3 cleavage products as assessed by Western blot in livers from chow- and NASH diet-fed mice.
  • FIG. 1 Adipsin/C3a effects on liver fibrosis.
  • A. Complement C3 cleavage products as assessed by Western blot in conditioned medium from hepatocytes with or without Adipsin expression.
  • B. Gene expression in hepatic stellate cells (HSC) after treatment with vehicle or recombinant C3a.
  • Figure 4 Reversal of NASH diet induced fibrosis.
  • A Reversal of NASH diet-induced fibrosis with AAV8-TBG-shCfd.
  • B Reversal of NASH diet- induced fibrosis with GalNAc-siCfd.
  • the present invention provides a method of treating a subject afflicted with fatty liver disease comprising administering to the subject in need thereof a pharmaceutical composition comprising a pharmaceutical carrier and a compound that reduces Adipsin activity in liver cells in an amount effective to treat the subject.
  • reducing Adipsin activity comprises decreasing Adipsin levels in liver cells.
  • the treatment includes reducing the subject's hepatic triglyceride levels and/or fibrosis.
  • the pharmaceutical composition decreases Cfd expression, thereby decreasing adipsin in the liver cells.
  • the pharmaceutical composition inhibits interactions of Cfd and MASP-3, thereby decreasing adipsin in the liver cells.
  • the fatty liver disease is nonalcoholic fatty liver disease or nonalcoholic steatohepatitis.
  • the pharmaceutical composition comprises an inhibitor of C3aRl.
  • the pharmaceutical composition is targeted to the liver of the subject.
  • the administration of the Cfd inhibitor inhibits liver Cfd without significantly inhibiting Cfd elsewhere in the subject.
  • the Cfd inhibitor is a small molecule inhibitor, an oligonucleotide or an adenoviral vector.
  • the oligonucleotide is targeted to hepatocytes.
  • the oligonucleotide is modified to increase its stability in vivo.
  • the pharmaceutical composition is administered in combination with Notch-active therapies.
  • the Notch-active therapy comprises a Notchl decoy protein.
  • the Notchl decoy protein comprises (a) amino acids, the sequence of which is identical to the sequence of a portion of the extracellular domain of a human Notchl receptor protein and (b) amino acids, the sequence of which is identical to the sequence of an Fc portion of an antibody.
  • the Notch-active therapy comprises administering to the subject a Jagged inhibitor.
  • the Jagged inhibitor is small interfering RNA for JAG1.
  • composition as in pharmaceutical composition, is intended to encompass a product comprising the active ingredient(s) and the inert ingredient(s) that make up the carrier, as well as any product which results, directly or indirectly from combination, complexation, or aggregation of any two or more of the ingredients, or from dissociation of one or more of the ingredients, or from other types of reactions or interactions of one or more of the ingredients.
  • the effective amount refers to an amount which is capable of treating a subject having a tumor, a disease or a disorder. Accordingly, the effective amount will vary with the subject being treated, as well as the condition to be treated.A person of ordinary skill in the art can perform routine titration experiments to determine such sufficient amount.
  • the effective amount of a compound will vary depending on the subject and upon the particular route of administration used. Based upon the compound, the amount can be delivered continuously, such as by continuous pump, or at periodic intervals (for example, on one or more separate occasions). Desired time intervals of multiple amounts of a particular compound can be determined without undue experimentation by one skilled in the art. In one embodiment, the effective amount is between about lpg/kg - 10 mg/kg. In another embodiment, the effective amount is between about lOpg/kg - 1 mg/kg. In a further embodiment, the effective amount is lOOpg/kg.
  • Extracellular domain as used in connection with Notch receptor protein means all or a portion of Notch which (i) exists extracellularly (i.e. exists neither as a transmembrane portion or an intracellular portion) and (ii) binds to extracellular ligands to which intact Notch receptor protein binds.
  • the extracellular domain of Notch may optionally include a signal peptide ("sp").
  • sp signal peptide
  • Notch “Notch”, “Notch protein”, and “Notch receptor protein” are synonymous.
  • the terms “Notch-based fusion protein” and “Notch decoy” are synonymous.
  • the following Notch amino acid sequences are known and hereby incorporated by reference: Notchl (Genbank accession no. S18188 (rat)); Notch2 (Genbank accession no. NP_077334 (rat)); Notch3 (Genbank accession no. Q61982 (mouse)); and Notch4 (Genbank accession no. T09059 (mouse)).
  • Notchl Genbank accession no. S18188 (rat)
  • Notch2 Genebank accession no. NP_077334 (rat)
  • Notch3 Genebank accession no. Q61982 (mouse)
  • Notch4 Genebank accession no. T09059 (mouse)
  • the following Notch nucleic acid sequences are known and hereby incorporated by reference: Notchl (Genbank accession no.
  • Notch2 Genbank accession no. NM_024358 (rat), M99437 (human and AF308601 (human)
  • Notch3 Genbank accession no. NM_008716 (mouse) and XM_009303 (human)
  • Notch4 Genbank accession no. NM_010929 (mouse) and NM_004557 (human)).
  • Notch decoy protein means a fusion protein comprising a portion of a Notch receptor protein which lacks intracellular signaling components and acts as a Notch signaling antagonist.
  • Notch decoy proteins comprise all or a portion of a Notch extracellular domain including all or a portion of the EGF-like repeats present in the Notch extracellular domain.
  • Examples of Notch decoy proteins include fusion proteins which comprise (a) amino acids, the sequence of which is identical to the sequence of a portion of the extracellular domain of a human Notch receptor protein and (b) amino acids, the sequence of which is identical to the sequence of an Fc portion of an antibody. In some Notch decoy proteins (b) is located to the carboxy terminal side of (a).
  • Notch decoy proteins further comprise a linker sequence between (a) and (b).
  • Notch decoy proteins can be selected from the group consisting of human Notchl receptor protein, human Notch2 receptor protein, human Notch3 receptor protein and human Notch4 receptor protein.
  • the extracellular domain of the human Notch receptor protein is selected from the group consisting of Notchl EGF-like repeats 1-36, Notchl EGF-like repeats 1-13, Notchl EGF-like repeats 1-24, Notchl EGF-like repeats 9-23, Notchl EGF-like repeats 10-24, Notchl EGF-like repeats 9-36, Notchl EGF-like repeats 10-36, Notchl EGF-like repeats 14-36, Notchl EGF-like repeats 13-24, Notchl EGF-like repeats 14-24, Notchl EGF-like repeats 25-36, Notch4 EGF-like repeats 1-29, Notch4 EGF-like repeats 1-13, Notch4 EGF-like repeats 1-23, Notch4 EGF-like repeats 9-23, Notch4 EGF-like repeats 9-29, Notch4 EGF-like repeats 13-23, and Notch4 EGF-like repeats 21-29.
  • Notch decoy proteins can be found in U.S. Patent No. 7,662,919 B2, issued February 16, 2010, U.S. Patent Application Publication No. US 2010-0273990 A1, U.S. Patent Application Publication No. US 2011-0008342 A1, U.S. Patent Application Publication No. US 2011-0223183 A1 and PCT International Application No. PCT/US2012/058662; the entire contents of each of which are hereby incorporated by reference into this application.
  • polypeptide peptide
  • protein protein
  • amino acid residues can be naturally occurring or chemical analogues thereof.
  • Polypeptides, peptides and proteins can also include modifications such as glycosylation, lipid attachment, sulfation, hydroxylation, and ADP-ribosylation.
  • Subject shall mean any organism including, without limitation, a mammal such as a mouse, a rat, a dog, a guinea pig, a ferret, a rabbit and a primate. In one embodiment, the subject is a human.
  • Treating means either slowing, stopping or reversing the progression of a disease or disorder. As used herein, “treating” also means the amelioration of symptoms associated with the disease or disorder.
  • an "agents for the treatment of fatty liver disease” are any agent known to or thought to treat a fatty liver disease.
  • Agents for the treatment of obesity include, but are not limited to vitamin E, selenium, betadine, metformin, rosiglitazone, pioglitazone, insulin sensitizers, antioxidants, probiotics, Omega-3 DHA, pentoxifylline, anti-TNF-alpha, FXR agonists and GLP-1 agonists.
  • nucleic acid sequences are written left to right in 5'to 3'orientation and amino acid sequences are written left to right in amino- to carboxy-terminal orientation.
  • Amino acids may be referred to herein by either their commonly known three letter symbols or by the one-letter symbols recommended by the IUPAC-IUB Biochemical Nomenclature Commission. Nucleotides, likewise, may be referred to by their commonly accepted single-letter codes.
  • “combination” means an assemblage of reagents for use in therapy either by simultaneous, contemporaneous, or fixed dose combination delivery.
  • Simultaneous delivery refers to delivery of an admixture (whether a true mixture, a suspension, an emulsion or other physical combination) of the drugs.
  • the combination may be the admixture or separate containers of the agents that are combined just prior to delivery.
  • Contemporaneous delivery refers to the separate delivery of the agents at the same time, or at times sufficiently close together that an additive or preferably synergistic activity relative to the activity of either the agents is observed.
  • Fixed dose combination delivery refers to the delivery of two or more drugs contained in a single dosage form for oral administration, such as a capsule or tablet.
  • the compound which is capable of inhibiting Adipsin silences expression of a gene or silences transcription.
  • Non-limiting examples of oligonucleotides capable of inhibiting expression include antisense oligonucleotides, ribozymes, and RNA interference molecules.
  • Antisense oligonucleotides are nucleotide sequences which are complementary to a specific DNA or RNA sequence. Once introduced into a cell, the complementary nucleotides combine with natural sequences produced by the cell to form complexes and block either transcription or translation. Preferably, an antisense oligonucleotide is at least 11 nucleotides in length, but can be at least 12, 15, 20, 25, 30, 35, 40, 45, or 50 or more nucleotides long. Longer sequences also can be used. Antisense oligonucleotide molecules can be provided in a DNA construct and introduced into a cell as described above to decrease the level of target gene products in the cell.
  • Antisense oligonucleotides can be deoxyribonucleotides, ribonucleotides, or a combination of both. Oligonucleotides can be synthesized manually or by an automated synthesizer, by covalently linking the 5' end of one nucleotide with the 3' end of another nucleotide with non-phosphodiester internucleotide linkages such alkylphosphonates, phosphorothioates, phosphorodithioates, alkylphosphonothioates, alkylphosphonates, phosphoramidates, phosphate esters, carbamates, acetamidate, carboxymethyl esters, carbonates, and phosphate triesters.
  • Modifications of gene expression can be obtained by designing antisense oligonucleotides which will form duplexes to the control, 5', or regulatory regions of the gene. Oligonucleotides derived from the transcription initiation site, e.g., between positions -10 and +10 from the start site, are preferred. Similarly, inhibition can be achieved using "triple helix" base-pairing methodology. Triple helix pairing is useful because it causes inhibition of the ability of the double helix to open sufficiently for the binding of polymerases, transcription factors, or chaperons. Therapeutic advances using triplex DNA have been described in the literature (Nicholls et al., 1993, J Immunol Meth 165:81-91). An antisense oligonucleotide also can be designed to block translation of mRNA by preventing the transcript from binding to ribosomes.
  • Antisense oligonucleotides which comprise, for example, 1, 2, 3, 4, or 5 or more stretches of contiguous nucleotides which are precisely complementary to a target polynucleotide, each separated by a stretch of contiguous nucleotides which are not complementary to adjacent nucleotides, can provide sufficient targeting specificity for a target mRNA.
  • each stretch of complementary contiguous nucleotides is at least 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, or more nucleotides in length.
  • Noncomplementary intervening sequences are preferably 1, 2, 3, or 4 nucleotides in length.
  • One skilled in the art can easily use the calculated melting point of an antisense-sense pair to determine the degree of mismatching which will be tolerated between a particular antisense oligonucleotide and a particular target polynucleotide sequence.
  • Antisense oligonucleotides can be modified without affecting their ability to hybridize to a target polynucleotide. These modifications can be internal or at one or both ends of the antisense molecule.
  • internucleoside phosphate linkages can be modified by adding cholesteryl or diamine moieties with varying numbers of carbon residues between the amino groups and terminal ribose.
  • Modified bases and/or sugars such as arabinose instead of ribose, or a 3', 5'-substituted oligonucleotide in which the 3' hydroxyl group or the 5' phosphate group are substituted, also can be employed in a modified antisense oligonucleotide.
  • modified oligonucleotides can be prepared by methods well known in the art.
  • Ribozymes are RNA molecules with catalytic activity (Uhlmann et al., 1987, Tetrahedron. Lett. 215, 3539-3542). Ribozymes can be used to inhibit gene function by cleaving an RNA sequence, as is known in the art. The mechanism of ribozyme action involves sequence-specific hybridization of the ribozyme molecule to complementary target RNA, followed by endonucleolytic cleavage. Examples include engineered hammerhead motif ribozyme molecules that can specifically and efficiently catalyze endonucleolytic cleavage of specific nucleotide sequences.
  • the coding sequence of a polynucleotide can be used to generate ribozymes which will specifically bind to mRNA transcribed from the polynucleotide.
  • Methods of designing and constructing ribozymes which can cleave other RNA molecules in trans in a highly sequence specific manner have been developed and described in the art.
  • the cleavage activity of ribozymes can be targeted to specific RNAs by engineering a discrete "hybridization" region into the ribozyme.
  • the hybridization region contains a sequence complementary to the target RNA and thus specifically hybridizes with the target RNA.
  • Specific ribozyme cleavage sites within an RNA target can be identified by scanning the target molecule for ribozyme cleavage sites which include the following sequences: GUA, GUU, and GUC. Once identified, short RNA sequences of between 15 and 20 ribonucleotides corresponding to the region of the target RNA containing the cleavage site can be evaluated for secondary structural features which may render the target inoperable. Suitability of candidate RNA targets also can be evaluated by testing accessibility to hybridization with complementary oligonucleotides using ribonuclease protection assays. Longer complementary sequences can be used to increase the affinity of the hybridization sequence for the target.
  • the hybridizing and cleavage regions of the ribozyme can be integrally related such that upon hybridizing to the target RNA through the complementary regions, the catalytic region of the ribozyme can cleave the target.
  • Ribozymes can be introduced into cells as part of a DNA construct. Mechanical methods, such as microinjection, liposome-mediated transfection, electroporation, or calcium phosphate precipitation, can be used to introduce a ribozyme-containing DNA construct into cells in which it is desired to decrease target gene expression. Alternatively, if it is desired that the cells stably retain the DNA construct, the construct can be supplied on a plasmid and maintained as a separate element or integrated into the genome of the cells, as is known in the art.
  • a ribozyme-encoding DNA construct can include transcriptional regulatory elements, such as a promoter element, an enhancer or VAS element, and a transcriptional teminator signal, for controlling transcription of ribozymes in the cells (U.S. 5,641,673). Ribozymes also can be engineered to provide an additional level of regulation, so that destruction of mRNA occurs only when both a ribozyme and a target gene are induced in the cells.
  • RNAi interfering RNA
  • Interfering RNA or small inhibitory RNA (RNAi) molecules include short interfering RNAs (siRNAs), repeat-associated siRNAs (rasiRNAs), and micro-RNAs (miRNAs) in all stages of processing, including shRNAs, pri-miRNAs, and pre-miRNAs. These molecules have different origins: siRNAs are processed from double-stranded precursors (dsRNAs) with two distinct strands of base-paired RNA; siRNAs that are derived from repetitive sequences in the genome are called rasiRNAs; miRNAs are derived from a single transcript that forms base-paired hairpins. Base pairing of siRNAs and miRNAs can be perfect (i.e., fully complementary) or imperfect, including bulges in the duplex region.
  • Interfering RNA molecules encoded by recombinase-dependent transgenes of the invention can be based on existing shRNA, siRNA, piwi- interacting RNA (piRNA), micro RNA (miRNA), double-stranded RNA (dsRNA), antisense RNA, or any other RNA species that can be cleaved inside a cell to form interfering RNAs, with compatible modifications described herein.
  • an "shRNA molecule” includes a conventional stem-loop shRNA, which forms a precursor miRNA (pre-miRNA).
  • shRNA also includes micro-RNA embedded shRNAs (miRNA-based shRNAs), wherein the guide strand and the passenger strand of the miRNA duplex are incorporated into an existing (or natural) miRNA or into a modified or synthetic (designed) miRNA.
  • a shRNA may form a primary miRNA (pri-miRNA) or a structure very similar to a natural pri-miRNA.
  • pri-miRNA is subsequently processed by Drosha and its cofactors into pre-miRNA. Therefore, the term "shRNA” includes pri- miRNA (shRNA-mir) molecules and pre-miRNA molecules.
  • a “stem-loop structure” refers to a nucleic acid having a secondary structure that includes a region of nucleotides which are known or predicted to form a double strand or duplex (stem portion) that is linked on one side by a region of predominantly single-stranded nucleotides (loop portion).
  • the terms “hairpin” and “fold-back” structures are also used herein to refer to stem-loop structures. Such structures are well known in the art and the term is used consistently with its known meaning in the art.
  • the secondary structure does not require exact base-pairing.
  • the stem can include one or more base mismatches or bulges.
  • the base-pairing can be exact, i.e. not include any mismatches.
  • RNAi-expressing construct or "RNAi construct” is a generic term that includes nucleic acid preparations designed to achieve an RNA interference effect.
  • An RNAi-expressing construct comprises an RNAi molecule that can be cleaved in vivo to form an siRNA or a mature shRNA.
  • an RNAi construct is an expression vector capable of giving rise to a siRNA or a mature shRNA in vivo.
  • vectors that may be used in accordance with the present invention are described herein and will be well known to a person having ordinary skill in the art. Exemplary methods of making and delivering long or short RNAi constructs can be found, for example, in WOOl/68836 and WO01/75164.
  • RNAi is a powerful tool for in vitro and in vivo studies of gene function in mammalian cells and for therapy in both human and veterinary contexts. Inhibition of a target gene is sequence-specific in that gene sequences corresponding to a portion of the RNAi sequence, and the target gene itself, are specifically targeted for genetic inhibition. Multiple mechanisms of utilizing RNAi in mammalian cells have been described. The first is cytoplasmic delivery of siRNA molecules, which are either chemically synthesized or generated by DICER-digestion of dsRNA. These siRNAs are introduced into cells using standard transfection methods. The siRNAs enter the RISC to silence target mRNA expression.
  • shRNA short hairpin RNA
  • miRNA micro interfering RNA
  • Conventional shRNAs which mimic pre-miRNA, are transcribed by RNA Polymerase II or III as single-stranded molecules that form stem-loop structures. Once produced, they exit the nucleus, are cleaved by DICER, and enter the RISC as siRNAs.
  • shRNAmir primary miRNA
  • pre- miRNA transcripts Flewell et al., 2006.
  • miR-30 miRNA construct An example is the miR-30 miRNA construct. The use of this transcript produces a more physiological shRNA that reduces toxic effects.
  • the shRNAmir is first cleaved to produce shRNA, and then cleaved again by DICER to produce siRNA.
  • the siRNA is then incorporated into the RISC for target mRNA degradation.
  • aspects of the present invention relate to RNAi molecules that do not require DICER cleavage. See, e.g., U.S. Patent No. 8,273,871, the entire contents of which are incorporated herein by reference.
  • RISC RNA Induced Silencing Complex
  • RLC RISC-loading complex
  • the guide strand leads the RISC to cognate target mRNAs in a sequence- specific manner and the Slicer component of RISC hydrolyses the phosphodiester bound coupling the target mRNA nucleotides paired to nucleotide 10 and 11 of the RNA guide strand.
  • Slicer forms together with distinct classes of small RNAs the RNAi effector complex, which is the core of RISC. Therefore, the "guide strand" is that portion of the double-stranded RNA that associates with RISC, as opposed to the "passenger strand,” which is not associated with RISC.
  • the number of nucleotides which is complementary to a target sequence is 16 to 29, 18 to 23, or 21-23, or 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, or 25.
  • RNA molecules can mediate RNAi. That is, the isolated RNA molecules of the present invention mediate degradation or block expression of mRNA that is the transcriptional product of the gene. For convenience, such mRNA may also be referred to herein as mRNA to be degraded.
  • mRNA RNA to be degraded.
  • RNA, RNA molecule(s), RNA segment(s) and RNA fragment(s) may be used interchangeably to refer to RNA that mediates RNA interference.
  • RNA double-stranded RNA
  • small interfering RNA hairpin RNA
  • single-stranded RNA isolated RNA (partially purified RNA, essentially pure RNA, synthetic RNA, recombinantly produced RNA), as well as altered RNA that differs from naturally occurring RNA by the addition, deletion, substitution and/or alteration of one or more nucleotides.
  • alterations can include addition of non-nucleotide material, such as to the end(s) of the RNA or internally (at one or more nucleotides of the RNA).
  • Nucleotides in the RNA molecules of the present invention can also comprise nonstandard nucleotides, including non-naturally occurring nucleotides or deoxyribonucleotides. Collectively, all such altered RNAi molecules are referred to as analogs or analogs of naturally- occurring RNA. RNA of the present invention need only be sufficiently similar to natural RNA that it has the ability to mediate RNAi.
  • RNA molecules that mediates RNAi interacts with the RNAi machinery such that it directs the machinery to degrade particular mRNAs or to otherwise reduce the expression of the target protein.
  • the present invention relates to RNA molecules that direct cleavage of specific mRNA to which their sequence corresponds. It is not necessary that there be perfect correspondence of the sequences, but the correspondence must be sufficient to enable the RNA to direct RNAi inhibition by cleavage or blocking expression of the target mRNA.
  • an RNAi molecule of the invention is introduced into a mammalian cell in an amount sufficient to attenuate target gene expression in a sequence specific manner.
  • the RNAi molecules of the invention can be introduced into the cell directly,or can be complexed with cationic lipids, packaged within liposomes, or otherwise delivered to the cell.
  • the RNAi molecule can be a synthetic RNAi molecule, including RNAi molecules incorporating modified nucleotides, such as those with chemical modifications to the 2'-OH group in the ribose sugar backbone, such as 2'-0-methyl (2'0Me), 2'-fluoro (2'F) substitutions, and those containing 2'0Me, or 2'F, or 2'-deoxy, or "locked nucleic acid" (LNA) modifications.
  • an RNAi molecule of the invention contains modified nucleotides that increase the stability or half-life of the RNAi molecule in vivo and/or in vitro.
  • the RNAi molecule can comprise one or more aptamers, which interact(s) with a target of interest to form an aptamer:target complex.
  • the aptamer can be at the 5' or the 3' end of the RNAi molecule.
  • Aptamers can be developed through the SELEX screening process and chemically synthesized.
  • An aptamer is generally chosen to preferentially bind to a target.
  • Suitable targets include small organic molecules, polynucleotides, polypeptides, and proteins. Proteins can be cell surface proteins, extracellular proteins, membrane proteins, or serum proteins, such as albumin. Such target molecules may be internalized by a cell, thus effecting cellular uptake of the shRNA.
  • Other potential targets include organelles, viruses, and cells.
  • RNA molecules of the present invention in general comprise an RNA portion and some additional portion, for example a deoxyribonucleotide portion.
  • the total number of nucleotides in the RNA molecule is suitably less than in order to be effective mediators of RNAi.
  • the number of nucleotides is 16 to 29, more preferably 18 to 23, and most preferably 21-23.
  • CRISPR clustered regularly interspaced short palindromic repeats
  • Cas9 Cas9 nuclease
  • Polynucleotides containing these foreign sequences and the repeat-spacer elements of the CRISPR locus are in turn transcribed in a host cell to create a guide RNA, which can subsequently anneal to a particular sequence and localize the Cas9 nuclease to this site.
  • highly site-specific cas9- mediated DNA cleavage can be engendered in a foreign polynucleotide because the interaction that brings cas9 within close proximity of the DNA molecule of interest is governed by RNA:DNA hybridization.As a result, one can theoretically design a CRISPR/Cas system to cleave any DNA molecule of interest.
  • ZFNs zinc finger nucleases
  • TALENs transcription activator-like effector nucleases
  • ZFNs and TALENs in genome editing applications is described, e.g., in Urnov et al., Nature Reviews Genetics 11:636 (2010); and in Joung et al., Nature Reviews Molecular Cell Biology 14:49 (2013), the disclosure of each of which are incorporated herein by reference as they pertain to compositions and methods for genome editing.
  • adenoviral vector encodes an oligonucleotide.
  • the use of adenoviral vectors in gene therapy and tissue-specific targeting has been described in Beatty and Curiel, 2012, Barnett et al., 2002, and Rots et al., 2003, the contents of which are incorporated herein by reference.
  • administering compounds in embodiments of the invention can be effected or performed using any of the various methods and delivery systems known to those skilled in the art.
  • the administering can be, for example, intravenous, oral, intramuscular, intravascular, intra arterial, intracoronary, intramyocardial, intraperitoneal, and subcutaneous.
  • Other non-limiting examples include topical administration,or coating of a device to be placed within the subject.
  • Injectable drug delivery systems may be employed in the methods described herein include solutions, suspensions, gels.
  • Oral delivery systems include tablets and capsules. These can contain excipients such as binders (e.g., hydroxypropylmethylcellulose, polyvinyl pyrilodone,other cellulosic materials and starch),diluents (e.g., lactose and other sugars, starch, dicalcium phosphate and cellulosic materials), disintegrating agents (e.g., starch polymers and cellulosic materials) and lubricating agents (e.g., stearates and talc).
  • Solutions, suspensions and powders for reconstitutable delivery systems include vehicles such as suspending agents (e.g., gums, zanthans, cellulosics and sugars), humectants (e.g., sorbitol), solubilizers (e.g., ethanol, water, PEG and propylene glycol), surfactants (e.g., sodium lauryl sulfate, Spans
  • an Adipsin inhibitor may be combined with any oral, non-toxic, pharmaceutically acceptable inert carrier such as ethanol, glycerol, water, and the like.
  • a pharmaceutically acceptable carrier is a pharmaceutically acceptable solvent, suspending agent or vehicle, for delivering the compounds to the subject.
  • the carrier may be liquid or solid and is selected with the planned manner of administration in mind.
  • Liposomes such as small unilamellar vesicles, large unilamallar vesicles, and multilamellar vesicles are also a pharmaceutically acceptable carrier. Liposomes can be formed from a variety of phospholipids, such as cholesterol, stearylamine, or phosphatidylcholines. The compounds may be administered as components of tissue-targeted emulsions.
  • lipid carriers for antisense delivery are disclosed in U.S. Patent Nos. 5,855,911 and 5,417,978, which are incorporated herein by reference.
  • the compounds used in the methods of the present invention can be administered in admixture with suitable pharmaceutical diluents, extenders, excipients, or carriers (collectively referred to herein as a pharmaceutically acceptable carrier) suitably selected with respect to the intended form of administration and as consistent with conventional pharmaceutical practices.
  • a pharmaceutically acceptable carrier suitably selected with respect to the intended form of administration and as consistent with conventional pharmaceutical practices.
  • the unit will be in a form suitable for oral, rectal, topical, intravenous or direct injection or parenteral administration.
  • the compounds can be administered alone or mixed with a pharmaceutically acceptable carrier.
  • This carrier can be a solid or liquid, and the type of carrier is generally chosen based on the type of administration being used.
  • the active agent can be co-administered in the form of a tablet or capsule, liposome, as an agglomerated powder or in a liquid form.
  • suitable solid carriers include lactose, sucrose, gelatin and agar.
  • Capsule or tablets can be easily formulated and can be made easy to swallow or chew; other solid forms include granules, and bulk powders. Tablets may contain suitable binders, lubricants, diluents, disintegrating agents, coloring agents, flavoring agents, flow-inducing agents, and melting agents.
  • suitable liquid dosage forms include solutions or suspensions in water, pharmaceutically acceptable fats and oils, alcohols or other organic solvents, including esters, emulsions, syrups or elixirs, suspensions, solutions and/or suspensions reconstituted from non-effervescent granules and effervescent preparations reconstituted from effervescent granules.
  • Such liquid dosage forms may contain, for example, suitable solvents, preservatives, emulsifying agents, suspending agents, diluents, sweeteners, thickeners, and melting agents.
  • Oral dosage forms optionally contain flavorants and coloring agents.
  • Parenteral and intravenous forms may also include minerals and other materials to make them compatible with the type of injection or delivery system chosen.
  • a compound of the invention can be administered in a mixture with suitable pharmaceutical diluents, extenders, excipients, or carriers (collectively referred to herein as a pharmaceutically acceptable carrier) suitably selected with respect to the intended form of administration and as consistent with conventional pharmaceutical practices.
  • a pharmaceutically acceptable carrier suitably selected with respect to the intended form of administration and as consistent with conventional pharmaceutical practices.
  • the unit will be in a form suitable for oral, rectal, topical, intravenous or direct injection or parenteral administration.
  • the compounds can be administered alone but are generally mixed with a pharmaceutically acceptable carrier.
  • This carrier can be a solid or liquid, and the type of carrier is generally chosen based on the type of administration being used. In one embodiment the carrier can be a monoclonal antibody.
  • the active agent can be co-administered in the form of a tablet or capsule, liposome, as an agglomerated powder or in a liquid form.
  • suitable solid carriers include lactose, sucrose, gelatin and agar.Capsule or tablets can be easily formulated and can be made easy to swallow or chew; other solid forms include granules, and bulk powders. Tablets may contain suitable binders, lubricants, diluents, disintegrating agents, coloring agents, flavoring agents, flow-inducing agents, and melting agents.
  • liquid dosage forms examples include solutions or suspensions in water, pharmaceutically acceptable fats and oils, alcohols or other organic solvents, including esters, emulsions, syrups or elixirs, suspensions, solutions and/or suspensions reconstituted from non- effervescent granules and effervescent preparations reconstituted from effervescent granules.
  • Such liquid dosage forms may contain, for example, suitable solvents, preservatives, emulsifying agents, suspending agents, diluents, sweeteners, thickeners, and melting agents.
  • Oral dosage forms optionally contain flavorants and coloring agents.
  • Parenteral and intravenous forms may also include minerals and other materials to make them compatible with the type of injection or delivery system chosen.
  • Tablets may contain suitable binders, lubricants, disintegrating agents, coloring agents, flavoring agents, flow-inducing agents, and melting agents.
  • the active drug component can be combined with an oral, non-toxic, pharmaceutically acceptable, inert carrier such as lactose, gelatin, agar, starch, sucrose, glucose, methyl cellulose, magnesium stearate, dicalcium phosphate, calcium sulfate, mannitol, sorbitol and the like.
  • Suitable binders include starch, gelatin, natural sugars such as glucose or beta-lactose, corn sweeteners, natural and synthetic gums such as acacia, tragacanth, or sodium alginate, carboxymethylcellulose, polyethylene glycol, waxes, and the like.
  • Lubricants used in these dosage forms include sodium oleate, sodium stearate, magnesium stearate, sodium benzoate, sodium acetate, sodium chloride, and the like.
  • Disintegrators include, without limitation, starch,methyl cellulose,agar,bentonite,xanthan gum, and the like.
  • Embodiments of the invention relate to specific administration to the liver or hepatocytes.
  • a compound may specifically target the liver.
  • a compound may specifically target hepatocytes.
  • a compound may be specifically targeted to the liver by coupling the compound to ligand molecules, targeting the compound to a receptor on a hepatic cell,or administering the compound by a bio-nanocapsule.
  • a compound of the invention can also be administered by coupling of ligand molecules, such as coupling or targeting moieties on preformed nanocarriers, such as (PGA-PLA nanoparticles, PLGA nanoparticles, cyclic RGD-doxorubicin-nanoparticles, and poly(ethylene glycol)- coated biodegradable nanoparticles), by the post-insertion method, by the Avidin-Biotin complex, or before nanocarriers formulation, or by targeting receptors present on various hepatic cell, such as Asialoglycoproein receptor (ASGP-R), HDL-R, LDL-R, IgA-R, Scavenger R, Transferrin R, and Insulin R, as described in: Mishra et al., (2013) Efficient Hepatic Delivery of Drugs:Novel Strategies and Their Significance, BioMed Research International 2013: 382184, dx.doi.org/10.1155/2013/382184, the entire contents of which are incorporated herein by reference.
  • a compound of the invention can also be administered by bio nanocapsule, as described in: Yu et al., (2005) The Specific delivery of proteins to human liver cells by engineered bio-nanocapsules, FEBS Journal 272: 3651-3660, dx.doi.org/10.1111/j.1742-4658.2005.04790.x, the entire contents of which are incorporated herein by reference.
  • an oligonucleotide specifically targets the liver.
  • an oligonucleotide specifically targets hepatocytes.
  • Antisense oligonucleotides of the invention can also be targeted to hepatocytes, as described in: Prakash et al., (2014) Targeted delivery of antisense oligonucleotides to hepatocytes using triantennary N-acetyl galactosamine improves potency 10-fold in mice, Nucleic Acids Research 42(13): 8796-8807, dx.doi.org/10.1093/nar/gku531, the entire contents of which are incorporated herein by reference.
  • the term "effective amount" refers to the quantity of a component that is sufficient to treat a subject without undue adverse side effects (such as toxicity, irritation, or allergic response) commensurate with a reasonable benefit/risk ratio when used in the manner of this invention, i.e. a therapeutically effective amount.
  • the specific effective amount will vary with such factors as the particular condition being treated, the physical condition of the patient, the type of subject being treated, the duration of the treatment, the nature of concurrent therapy (if any), and the specific formulations employed and the structure of the compounds or its derivatives.
  • the dosage of a compound of the invention administered in treatment will vary depending upon factors such as the pharmacodynamic characteristics of the compound and its mode and route of administration; the age, sex, metabolic rate, absorptive efficiency, health and weight of the recipient; the nature and extent of the symptoms; the kind of concurrent treatment being administered; the frequency of treatment with; and the desired therapeutic effect.
  • a dosage unit of the compounds of the invention may comprise a compound alone, or mixtures of a compound with additional compounds used to treat cancer.
  • the compounds can be administered in oral dosage forms as tablets, capsules, pills, powders, granules, elixirs, tinctures, suspensions, syrups, and emulsions.
  • the compounds may also be administered in intravenous (bolus or infusion), intraperitoneal, subcutaneous, or intramuscular form, or introduced directly, e.g. by injection or other methods, into the eye, all using dosage forms well known to those of ordinary skill in the pharmaceutical arts.
  • the compound that decreases adipsin activity may be administered once a day, twice a day, every other day, once weekly, or twice weekly.
  • 0.01 to 1000 mg of a compound that decreases adipsin activity is administered per administration.
  • Notch-active therapies i.e. siJagl
  • the targets here are based on a target identified as upregulated in hepatocytes derived from NASH diet-fed mice but are not direct Notch targets.
  • Adipsin the first adipokine described (Cook et al, 1987), cleaves complement factor C3 to C3a (and C3b), which activates the complement alternative pathway (Cianflone, Biochemistry, 1994).
  • Adipocyte expression of Cfd which encodes adipsin
  • circulating levels of adipsin paradoxically decline in mouse models of obesity, which may induce b cell failure to adapt to peripheral insulin resistance (Lo et al, 2014).
  • hepatocyte Cfd expression is somewhat lower (in HFD-fed mice) or unaffected (in NASH diet-fed mice), hepatocyte Cfd expression markedly and progressively increases with obesity, due to increased hepatocyte expression (Figure la-e). This increase does not make substantive contributions to circulating levels, but a parallel increase in C3 cleavage to C3a, consistent with the significant upregulation of liver C3 activation in patients with NASH is seen (Rensen et al, 2009).
  • FIG. 2A shows Adipsin gene expression in isolated hepatocytes (parenchymal cells, PC) or various non-parenchymal cell (NPC) populations in chow- and NASH diet-fed mice. Adipsin expression was significantly higher in parenchymal cells of NASH diet fed mice than in chow diet fed mice, consistent with the suggestion that Adipsin plays a role in NASH.
  • Complement C3 gene expression was analyzed in isolated liver PC and NPC in chow- and NASH diet-fed mice ( Figure 2B).
  • Adipsin results in increased complement C3 cleavage products C3a and C3b, and these were assessed by Western blot in livers from chow- and NASH diet-fed mice.
  • the Western blot demonstrates higher levels of cleavage products in the livers of NASH diet-fed mice than chow diet-fed mice.
  • Figure 2D shows C3aRl gene expression level in isolated liver PC and NPC in chow- and NASH diet-fed mice, with the increase in the C3aRl receptor expression level indicating Adipsin induces increased infiltration of immune cells and stellate cells in the liver, consistent with disease.
  • Figure 3A shows complement C3 cleavage products as assessed by Western Blot in conditioned medium from hepatocytes with or without Adipsin expression.
  • Figure 3B shows gene expression in hepatic stellate cells (HSC) after treatment with vehicle or recombinant C3a.
  • HSC hepatic stellate cells
  • HSC hepatic stellate cells
  • Adipsin is a component of the alternative complement pathway, best known for its role in humoral suppression of infectious agents.
  • Adipsin Complement Factor D (CFD) activates the alternative complement pathway.
  • the complement system is a part of the immune system that enhances (complements) the ability of antibodies and phagocytic cells to clear microbes and damaged cells from an organism, promotes inflammation, and attacks the pathogen's cell membrane.
  • Adipsin is a serine protease secreted by adipocytes, and it cleaves factor B, resulting in increased C3a and C3b production.

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Abstract

La présente invention concerne le traitement de la maladie du foie gras. Plus spécifiquement, des modes de réalisation de l'invention concernent un transporteur de médicament et un composé qui réduit l'activité de l'adipsine dans les cellules hépatiques.
PCT/US2021/041999 2020-07-16 2021-07-16 Ciblage de l'adipsine pour la stéatohépatite non alcoolique (shna) et la fibrose hépatique Ceased WO2022016065A1 (fr)

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030092620A1 (en) * 2001-07-26 2003-05-15 Genset, S.A. Use of adipsin/complement factor D in the treatment of metabolic related disorders
US20110129469A1 (en) * 2009-11-03 2011-06-02 Acceleron Pharma Inc. Methods for treating fatty liver disease
US20170059587A1 (en) * 2015-09-01 2017-03-02 Abdulmohsen Ebrahim Alterki Method for diagnosing sleep apnea
US20200093900A1 (en) * 2014-03-13 2020-03-26 Dana-Farber Cancer Institute, Inc. Compositions and methods for regulating pancreatic beta cell function using adipsin

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030092620A1 (en) * 2001-07-26 2003-05-15 Genset, S.A. Use of adipsin/complement factor D in the treatment of metabolic related disorders
US20110129469A1 (en) * 2009-11-03 2011-06-02 Acceleron Pharma Inc. Methods for treating fatty liver disease
US20200093900A1 (en) * 2014-03-13 2020-03-26 Dana-Farber Cancer Institute, Inc. Compositions and methods for regulating pancreatic beta cell function using adipsin
US20170059587A1 (en) * 2015-09-01 2017-03-02 Abdulmohsen Ebrahim Alterki Method for diagnosing sleep apnea

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